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Lowering the Cost of Health Care

Five years ago, I got a terrifying call: my husband, Stan, had suffered a debilitating stroke. It changed our lives. For the next year before he passed away, I fought for him while he was in-and-out of hospitals and health care facilities, all while working full-time myself -- it was tough on our family.

But I knew, too, that what we were going through was no different than what thousands of other working Maine families were going through: facing a confusing and complex health care system, with increasing deductibles and premiums, and -- for many -- unaffordable co-pays and high prescription drug costs.

Today, there are still far too many people who are not able to get health insurance, and even for those who have insurance, many are paying very high premiums and high out of pocket expenses. In fact, the concerns I hear from those without coverage are not all that different from those who cannot afford what they do have – and meanwhile, there are businesses across the state who want to cover their employees, but simply cannot do so affordably.

We need a new direction

Health care is not a luxury. It is something we all need. It is a human right. As governor, my top priority will be to tackle the affordability and accessibility for hardworking, middle-class Mainers, businesses, and self-employed individuals across the state. The Affordable Care Act was a start at the federal level, but there is much more we can do in Maine to make health care accessible for all Mainers.

That is why I will:

Create the Small Business Access Plan: Maine small businesses and self-employed Mainers need more options. The network of Medicaid and private insurance leaves too many holes -- not only for those who do not have health insurance, but also for those who do not have affordable insurance. Small businesses and the self-employed also should not be held hostage by threats from insurance companies that they will pull out of the marketplace or that premiums must rise again. We can change that with a new health insurance option that aggregates state health plans and allows qualified small businesses and self-employed individuals to buy in. This will allow Maine people another choice that will increase competition in the health care market and achieve savings through aggressive bargaining and lower rates.

Protect Maine Consumers from Rollbacks of ACA Protections. The Affordable Care Act made critical strides in ensuring that those with pre-existing conditions could obtain affordable health insurance and that essential benefits, like mental health and maternity and newborn care are covered. Politicians across America – including Governor LePage here in Maine -- are working both in court and in Congress to roll-back those protections. I will work with the State Legislature to codify in Maine law these vital protections. Maine law offers some protections now, but they are not strong enough. Under my Administration, no Mainer with a pre-existing condition will have to worry about what happens at the federal level because we will make sure they are protected here in Maine.

Implement Medicaid Expansion. The voters overwhelmingly approved Medicaid expansion at the ballot box – it is the law and it is smart public policy that will help lower the cost of health care for Maine businesses, infuse half a billion dollars of federal money into Maine’s economy, create an estimated 6,000 jobs, save our rural hospitals, and provide cost-effective preventive care to 70,000 people. That’s why I found $35 million to fund it. I hope Medicaid expansion is implemented before I become governor, but if it’s not, I will do it on Day One and work to implement reasonable cost controls to ensure that it remains affordable in the future.

Lower the Cost of Prescription Drugs. Maine people are still paying too much for prescription medications. I have stood up to Big Pharma as your Attorney General and I will continue to do so as governor. Maine needs to provide greater transparency in pricing so that people can make informed decisions. My administration will reverse Governor LePage’s cuts to the Drugs for the Elderly and Medicare Savings Programs. Also, several states are taking innovative steps to get around the traditional barriers. My administration will look to build on programs that work in Maine while stepping in quickly if solutions pioneered elsewhere take hold. We will watch closely Vermont’s recent move to facilitate wholesale reimportation from Canada. Similarly, Maryland has begun a bold attempt to implement a payment cap on certain common drugs. My administration will investigate pooling the purchasing power of public health plans to negotiate better deals for those systems and hold PBMs to strict financial scrutiny.

Support Well-Regulated Association Health Plans. Association Health Plans allow small businesses to join together the purchase health insurance, and they can play a role in helping lower the cost of health care. My Administration will support the growth of AHPs, so long as they are well-regulated and provide a reasonable product with robust and affordable benefits to all, regardless of age, gender, geography, or other factors.

Rebuild Maine’s Public Health Infrastructure. The current administration has devastated Maine’s public health infrastructure. Serious public health challenges - like the opioid crisis and our increasing infant mortality rate - have gone unaddressed and are impacting Maine’s future. I will turn this around by hiring public health nurses, expanding the vaccination program, funding school-based health centers, and advancing telemedicine which will yield significant benefits for our rural communities.

Streamline and Improve Maine’s Mental Health Care System. Like many Mainers, I have a family member with mental illness and am keenly aware of the issues that people across the state confront when trying to access care. Our mental health system is inadequate and is in urgent need of fixing. The warehousing of those with mental illness in our jails is wrong, and it is imperative that we reorient our mental health system to ensure that those with mental illness are able to access the care they need. I will do that in several steps:

by addressing the backlog that prevents people from receiving community services,

by fully implementing the Consent Decree for current or former Riverview patients, and

by building up intensive community based treatment, such as the ACT program.

Reform the Department of Health and Human Services. The LePage Administration’s DHHS has mishandled taxpayer money, concealed details from the public, shifted funds away from programs like the Supplemental Nutrition Assistance Program, and allowed critical dollars to stockpile while Maine families, including children, grow poorer and hungrier. I will put those dollars into improving the health and welfare of Maine people like they were intended, and I will order an immediate audit of the Medicaid account to determine where those tax dollars have gone. Importantly, I will appoint a commissioner who is not only an experienced manager but a leader who understands DHHS’s core mission. Doing so will reorient the focus of the agency to ensure that we effectively take care of Maine’s most vulnerable population.